The proposed study addresses the effect of a nurse delivered self-efficacy enhancement intervention of dietary compliance. Nutrition is assuming an increasingly important role in the prevention and management of chronic conditions yet reports of dietary noncompliance continue to range from 10- 8%. Patients with hyperlipidemia will serve as the model to test the proposed intervention. The association between an elevated serum cholesterol level and the development of coronary heart disease (CHD) is well established. It is estimated that approximately 64 million Americans aged 20 years and older are candidates for medical advice and/or treatment for elevated cholesterol levels. Dietary management is the cornerstone of treatment. This study will use a randomized controlled two group design to test the effectiveness of a cognitive-behavioral intervention to improve dietary compliance. Eighty-eight patients aged 20-74 years attending the Nutrition Lipid and Cardiac Rehabilitation Programs at the U. of Pittsburgh, with a low density lipoprotein (LDL)-cholesterol level of >130mg/dl will comprise the sample. Females will be recruited in equal proportion to males. The self-efficacy model, which comes from self- efficacy theory, is the basis of the cognitive-behavioral intervention. Self-efficacy is based on an interactive model of human behavior (cognitive, behavioral, environment) and focuses on individually perceived assessments of abilities related to the performance of specific behaviors. The self-efficacy intervention will be delivered primarily through telephone sessions, and will include four major components:knowledge enhancement and reinforcement, skill development, goal setting and self- regulation. Compliance, the primary outcome, will be measured by self- reported diet intake and self-efficacy by an instrument to be developed by the investigator. Serum lipid levels will be measured pre- and post- intervention and examined for a relationship with changes in self-reported dietary compliance. If the intervention is successful it can be applied by nurses to prescribed diets in multiple settings and increase the effectiveness of the treatment and the nurse's intervention.